Low uptake of Covid vaccines is fuelling concerns of a ticking time bomb for the NHS, which is already under huge winter pressure
The number of people taking up the offer of a free Covid booster jab has fallen sharply this autumn, fuelling fears of a “quad-demic” of rising flu, Covid, norovirus and common cold cases over Christmas.
According to the latest data, cases of flu, norovirus and respiratory syncytial virus (RSV) – a major cause of the common cold – are already shooting up – while Covid cases are at relatively low levels with hospitalisations rising only slightly in the week to Sunday, 1 December.
But scientists fear that Covid will start to rise again in the run-up to Christmas and they are concerned that any increase will be accelerated by the low level of vaccine uptake this autumn – which is 14 per cent below what it was at the same time last year.
They are also concerned by a reduced uptake of flu vaccines this year, with flu cases four times as high now as they were this time last year.
Scientists told The i Paper they fear that this low uptake of Covid and flu vaccines will exacerbate the winter crisis facing the NHS.
Around 9.3 million people in England, out of the estimated 20 million who are eligible, had a Covid jab in the first nine weeks of the autumn booster campaign (up until 1 December) – compared with 10.8 million in the first nine weeks of the 2023 campaign, according to figures from NHS England, analysed by Bob Hawkins, a data scientist who works with Independent Sage.
The low uptake among under-65s with weakened immune systems is particularly concerning, with just 22 per cent of those eligible in England and 19 per cent in Scotland taking up the jab by 1 December – and 14 per cent in Wales, by November 28.
Health leaders warned last week that the service is already in the grips of a “quad-demic” of rising cases of flu, Covid-19, norovirus and respiratory syncytial virus (RSV), with beds running out and A&E services on the brink of declaring critical incidents.
Professor Steve Griffin, a virologist at Leeds University, said: “It is very worrying how certain eligible groups are not taking up the offer of vaccines – pregnant women and at-risk under-65s in particular, both for influenza and Covid. Vaccines do help prevent many severe cases of these diseases.”
Paul Hunter, a professor in medicine at the University of East Anglia, also said the low uptake rates were “concerning”.
“We always get an increase in flu, RSV and norovirus at about this time of year and Covid has also tended to increase during the winter months,” he said. “I am concerned about the impact of the winter epidemics. The NHS is already under severe pressure and it probably has less resilience than pre-Covid.”
Professor Sir Stephen Powis, national medical director for NHS England, said flu cases are “skyrocketing”.
“It’s now or never for older people and children to get themselves jabbed and protected ahead of any family get-togethers they have planned over the festive period,” he said.
Dr Alexander Allen, consultant epidemiologist at the UK Health Security Agency (UKHSA), added: “Anyone still eligible for the flu, Covid-19 or RSV vaccines should get booked in ahead of the busy winter holiday period, when we expect flu, and other respiratory viruses to spread between people more easily”.
According to the UKHSA, flu vaccine uptake data indicates that just 36 per cent of those under 65 years in a clinical risk group have had their flu jab, compared to 38.3 per cent at the same point last year – with 71.4 per cent of all those aged 65 years and over taking up the offer, compared to 75.9 per cent last year.
Meanwhile, flu jab uptake among pregnant women is slightly higher this year but remains low, at 31.9 per cent, compared to 27.7 per cent last year, according to the UKHSA.
The low flu vaccine uptake comes as the proportion of people in England with flu symptoms testing positive for the virus in the national laboratory reporting system rose by 68 per cent in the week to 1 December, while hospitalisations more than doubled over the same period.
Professor Susan Hopkins, chief medical advisor at UKHSA, said: “Unless more of those eligible to receive a flu vaccine come forward, we are likely to see more hospitalisations and deaths than we saw last year.
“It is still early in the season, so there is still time to change the trajectory and reduce the impact of flu in our communities in time for Christmas, but time is running out.”
Who is offered a Covid jab – and why they aren’t taking it
The number of people eligible for a Covid booster jab this autumn is estimated to be several hundred thousand fewer than last year because carers and household contacts of those with weakened immune systems are no longer eligible.
But this only amounts to a reduction of around 1 to 3 per cent in those who are eligible, compared to a 14 per cent drop in the uptake of jabs – while that group has traditionally had a fairly low uptake of the vaccine anyway, scientists said.
The shortfall of Covid vaccinations compared to 2022 is even greater, when 17.6 million took up the offer in the first nine weeks – although 26 million were eligible that year, as all over-50s were offered a free jab, rather than all over-65s in 2023 and 2024.
Eligibility aside, the number of jabs at this point in the campaign this year is barely half that of two years ago and more than 10 per cent below last year, scientists pointed out.
The problem is further compounded because this year’s autumn campaign is much shorter than before, running from 3 October to 20 December – just 81 days, compared to 150 days last year – although some deprived communities will be able to get the vaccine this year until the end of January.
Eligibility for Covid vaccines can be checked and boosters booked at this link and here for flu. Both campaigns end on 20 December.
‘Quad-demic’ latest: Cases on the rise
According to the latest UKHSA figures, the flu “positivity rate” jumped by 68 per cent, to 11.1 per cent, in the week to 1 December while hospitalisations more than doubled over the same period, to 3.96 per 100,000 of the population.
The RSV positivity rate, meanwhile, jumped by 14 per cent to 15.5 per cent.
Positivity rates – the proportion of people with symptoms testing positive in the national laboratory reporting system – are typically much higher than infection rates in the general population. But scientists say they give a good indication of trends
Meanwhile, norovirus cases were 43.9 per cent higher in the two-week period between 11 to 24 November than the previous two-week period, fuelled by a new dominant variant, according to the UKHSA.